What now for health reform?
By Mike Dennison
Helena Independent Record
02/08/09
With last week’s political demise of Tom Daschle, the man expected to shepherd serious health care reform through the minefield of Congress, has reform been dealt a deadly blow?
Not according to Montana’s senior U.S. senator, Max Baucus, who said in no uncertain terms last week that he remains committed to enacting “comprehensive health care reform” this year.
Baucus, the chairman of the Senate Finance Committee, and U.S. Sen. Ted Kennedy, D-Mass., who chairs the Senate Health Committee, sent a strongly worded letter to President Barack Obama in the wake of Daschle’s withdrawal of his nomination to be Obama’s secretary of health and human services.
In the letter, Baucus and Kennedy said we have a “moral duty” to ensure that every American gets quality health care, and that “we must act now” to confront rising health-care costs, growing numbers of people without health insurance, and the fact that America spends far more on health care than any other developed nation.
“Incremental efforts will no longer suffice and we cannot afford to wait any longer,” they wrote. “We remain certain that our goal of enacting comprehensive health care reform can be accomplished this year.”
You can’t state things much more directly than that. Of course, the question then becomes, what sort of health care reform might we get? What is the “comprehensive” reform that Baucus and Kennedy have in mind, and how will it work for all of us?
We’ll get to those questions, but first, let’s just say that devotees of health care reform shouldn’t be shedding too many tears at the demise of Daschle.
Daschle, the former Democratic U.S. senator from South Dakota, withdrew as nominee for health and human services secretary after it was revealed he hadn’t paid $128,000 in taxes on a car and driver provided him by an investment firm.
While it was the tax problems that probably sunk Daschle, it wasn’t the only thing that should have given people pause. As reported by the New York Times last week, the former senator had been receiving lots of money from lots of high-powered interests for “advice” on things political.
Those interests included UnitedHealth, the nation’s largest health insurer that had more than $25 billion in revenue last year from selling Medicare-related private insurance plans, and the Mayo Clinic, for whom Daschle helped beat back a government loan to a company that wanted to build a freight rail line near the clinic’s Rochester, Minn., campus.
So, this is the guy who was supposed to be the Flying V wedge on health care reform, plowing through the entrenched lobbies that want to muck up any attempts to dislodge their profits?
Which brings us back to Sen. Baucus, who told us last week that health care reform in America will include “both public and private coverage,” and that he’ll be carrying legislation that will have “a very strong incentive for private (insurance) coverage.”
Baucus hasn’t rolled out any bills yet, but in December he said he wants to require everyone to buy health insurance and take steps to ensure that the insurance will be affordable. The actual details of his multi-pronged approach are much more complex, but that’s the general idea, along with expansion of some public-insurance programs like Medicare and the Children’s Health Insurance Program.
He also reiterated last week that he won’t support or even consider a Medicare-for-all system that would extend government coverage to everyone, financed by taxes.
“I just have to make a judgment, and I think at this time in this country that single-payer is not going to get even to first base in Congress,” he said at a Washington, D.C., conference on health policy conference.
Sara Kuban, spokeswoman for Baucus in Washington, D.C., said Friday that Baucus doesn’t want to waste time pursuing policies “all but certain to fail,” because he thinks reform is urgently needed.
As reported by Congressional Quarterly, Baucus also said at the D.C. conference that single-payer or Medicare-for-all would be too drastic of a change and too much of a government takeover of the private (insurance) sector.
“We’re a big country,” he said. “We’re a battleship, an ocean liner. It takes time to turn big ships. You can’t just turn them overnight.”
He’s certainly correct on that account. However, Medicare-for-all advocates have an answer, and that’s to phase in Medicare coverage for everyone over several years, adding groups of the population at a time.
Of course, Medicare-for-all isn’t the only way to skin the health care reform cat. Other models of national systems exist around the world, including those that have private health insurance. But the common denominator in these latter types is that for-profit insurance is all but eliminated, having highly regulated, non-profit insurance instead.
Sure, turning a big ship isn’t easy. But you have to have the political will to do it and you need to turn it in the right direction. It’s up to average citizens to keep the pressure on those making the political decisions on the critical issue of health care reform, because the policy-makers will be hearing plenty from the UnitedHealths and Mayo Clinics of the world.
Next week, we’ll take a look at how health care reform happened in other countries — and what it might mean for the path of reform here in America.
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